operator has frequently placed a safe distance between himself and his patients of the day before, and is seeking fresh dupes in another village. [Illustration: Fig. 9.--Instruments used in Couching.] =The Posterior Operation.=--Much that has been written on the preceding method applies with equal force to this. It is, however, possible to describe the technique much more accurately, as it has been carefully studied at first-hand by Dr. Ekambaram, who for many years worked under the writer in the Government Ophthalmic Hospital, Madras. His original description of the method will well repay a careful perusal. He speaks of the operators as being ambidextrous and very skilful. Their surgical equipment (Fig. 9) for the operation consists of a small lancet-shaped knife, guarded to within a few millimetres of its tip by a roll of cotton-wool, wrapped round it for the purpose, and of a copper probe 4 inches long and about 1-1/2 mm. in diameter. A cotton thread twisted round this probe at a spot 12 mm. from its point serves the same purpose as the stop in the Bowman’s needle. From the point to this stop the instrument is triangular in section. The patient is directed to look well towards the nose, and the surgeon then gently marks out the selected spot by pressing with his thumbnail on the conjunctiva covering the sclera, about 8 mm. out from the cornea, and about 2 mm. below the horizontal meridian. In some cases the operator steadies the eye by firm digital pressure exerted through the partly everted lower lid. He next takes his lancet in his hand, and it will be observed from the illustration (Fig. 9) that it might easily pass for a roll of cotton-wool; this, indeed, is what the patient is led to believe it really is. To heighten such an impression, the point is covered with a sandalwood paste, prepared beforehand _coram publico_, with a good deal of ostentation. The patient is informed that this “cataract-cleansing drug is about to be applied to the eye,” and under cover of the suggestion the operator plunges the lancet through the tunic of the globe at the spot already selected. The alarm thus occasioned is allayed by the assurance that the “medicinal application” is over. The copper probe is next produced, and is inserted through the wound up to its stop, being held between the thumb and two fingers; a circular movement is given to its point, the stop resting against the puncture, and serving as a pivot for the movement. According to Ekambaram, the object is to tear through the suspensory ligament from behind. Immediately following this step, a downward stroke of the point is made in order to depress the now loosened lens. Ekambaram graphically describes the care taken by these operators to impress, alike on the patient and on the friends, the magical effects of the procedure. The former is shown a number of objects, and is bidden to name them in turn, and to state their colour. The crowning point is